Debate on Organ Donation: Opt-In vs Opt-Out Approach Comparison
Organ donation policies worldwide differ significantly, and the question remains whether an opt-in or opt-out system works best. To investigate, researchers from the UK delved into the organ donation protocols of 48 countries.
In an opt-in system, people must actively sign up to a donor register for their organs to be used posthumously. On the other hand, in an opt-out system, organ donation occurs automatically unless the individual explicitly states before death that their organs should not be utilized.
Prof. Eamonn Ferguson, the lead author from the University of Nottingham, acknowledges that the reliance on individual decisions in both systems may lead to drawbacks:
"People may not act for a variety of reasons, including loss aversion, lack of effort, and a belief that policy makers have made the 'right' decision."
Inactivity in an opt-in system can result in individuals who would have wanted to donate not donating (a false negative). In contrast, inactivity in an opt-out system could potentially lead to an individual who does not wish to donate becoming one (a false positive).
The US adheres to an opt-in system. Last year, 28,000 transplants were made possible due to organ donors, with around 79 transplants happening every day. Regrettably, around 18 people die daily due to a shortage of donated organs.
Researchers from the University of Nottingham, University of Stirling, and Northumbria University in the UK examined organ donation systems in 48 countries over a 13-year period - 23 with an opt-in system, and 25 with an opt-out system.
The study revealed that countries with an opt-out policy had higher total numbers of kidneys donated - the organ most in demand by people on transplant waiting lists. Opt-out systems also had a higher overall number of organ transplants.
Opt-in systems, however, had a higher rate of kidney donations from living donors. The impact of policy on living donation rates, as Prof. Ferguson points out, "has not been reported before."
The authors acknowledge limitations in their study, such as not differentiating between varying degrees of opt-out legislation and not assessing other factors affecting organ donation.
The study's results suggest that opt-out consent may result in an increase in deceased donation but a decrease in living donation rates. They also found an increase in the total number of livers and kidneys transplanted.
The researchers propose that their findings could guide future decisions on policy and emphasize the importance of collecting and publicly sharing international organ donation data, such as consent type, procurement procedures, and hospital bed availability.
Future studies may also delve into the opinions and attitudes of individuals regarding organ donation, using a mix of surveys and experimental methods for a deeper understanding of how consent legislation affects organ donation and transplantation rates.
The authors note that countries with opt-out consent still experience donor shortages, suggesting that changing the consent system may not be the sole solution. They suggest that improving consent legislation or implementing aspects of the "Spanish Model" could aid in improving donor rates.
Spain boasts the world's highest organ donation rate, thanks to the Spanish utilization of opt-out consent and measures such as a transplant coordination network, operating locally and nationally, and enhancing the quality of public information available on organ donation.
Recently, Medical News Today ran a spotlight feature on the possibility of farming animal organs for human transplants. Could this be a solution to the organ shortage, or is it a problem best addressed through changes to organ donation policy?
- In the study on organ donation policies across 48 countries, researchers observed that opt-out systems led to a higher total number of kidneys donated.
- The authors of the study acknowledge that, despite opt-out systems having higher donation rates, countries with this policy still experience donor shortages.
- The study results suggest that opt-out consent may increase deceased donation but decrease living donation rates, and also found an increase in the total number of livers and kidneys transplanted.
- Researchers at the University of Nottingham, University of Stirling, and Northumbria University examined organ donation systems over a 13-year period and found that opt-in systems had a higher rate of kidney donations from living donors.
- There has been discussion within general-news and policy-and-legislation circles about the possibility of farming animal organs for human transplants, but whether this would solve the organ shortage or require changes to organ donation policy remains a subject of debate in the context of medical-conditions, health-and-wellness, science, politics, and general-news.
